Provider Demographics
NPI:1679797096
Name:HAWTHORNE, SUSAN CARNAHAN (LCSW)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:CARNAHAN
Last Name:HAWTHORNE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5944 LUTHER LN STE 402
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75225-5916
Mailing Address - Country:US
Mailing Address - Phone:214-368-8133
Mailing Address - Fax:214-368-1333
Practice Address - Street 1:5944 LUTHER LN
Practice Address - Street 2:SUITE402
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75225-5942
Practice Address - Country:US
Practice Address - Phone:214-368-8133
Practice Address - Fax:214-368-1333
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS204131041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical